The nurse is educating a client about an inhaled corticosteroid. What statement will the nurse include?
Take this medication before bedtime to minimize side effects.
Rinse your mouth after each use.
Stop taking the medication if you gain 5 or more pounds in 1 week.
Use this medication on an empty stomach to improve its effectiveness.
The Correct Answer is B
Choice A reason: Inhaled corticosteroids, such as fluticasone, are not specifically timed for bedtime to minimize side effects. Their primary effect is local anti-inflammatory action in the airways, with minimal systemic absorption. Timing does not significantly reduce side effects like oral thrush, which is managed by rinsing the mouth. Administration is typically twice daily for consistent asthma control, independent of bedtime.
Choice B reason: Rinsing the mouth after using inhaled corticosteroids is essential to prevent oral candidiasis (thrush). Residual corticosteroid in the oral cavity can disrupt the local microbial balance, promoting fungal overgrowth. Rinsing removes excess drug, reducing infection risk while maintaining the drug’s anti-inflammatory effect in the airways, ensuring safe and effective therapy.
Choice C reason: Weight gain of 5 pounds in a week is not a typical side effect of inhaled corticosteroids due to their minimal systemic absorption. Stopping the medication abruptly could exacerbate asthma symptoms. Significant weight gain is more associated with systemic corticosteroids, which affect metabolism and fluid retention, unlike inhaled formulations.
Choice D reason: Inhaled corticosteroids do not require an empty stomach for effectiveness, as they are delivered directly to the lungs via inhalation. Their local action on airway inflammation is independent of gastrointestinal absorption. Food intake does not influence their pharmacokinetics or therapeutic efficacy, making this instruction irrelevant for inhaled corticosteroid use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Fluticasone/salmeterol is a combination of an inhaled corticosteroid and a long-acting beta-2 agonist used for maintenance therapy to prevent bronchospasms in asthma or COPD. Fluticasone reduces inflammation, while salmeterol provides sustained bronchodilation, making it effective for long-term control, not acute relief.
Choice B reason: Using a spacer with fluticasone/salmeterol is not mandatory, though it may improve drug delivery in some patients. Spacers enhance lung deposition for metered-dose inhalers, but this combination is often delivered via dry powder inhalers, which do not require spacers, making this statement inaccurate.
Choice C reason: Avoiding water for 1 hour after using fluticasone/salmeterol is unnecessary. Patients should rinse their mouth after inhalation to prevent oral thrush, but water restriction is not required. The drug’s local action in the lungs is unaffected by oral hydration, making this instruction incorrect.
Choice D reason: Fluticasone/salmeterol is not indicated for acute therapy. Its slow onset (salmeterol takes 20-30 minutes) makes it unsuitable for acute bronchospasm. It is used for maintenance to prevent symptoms, while short-acting beta-agonists like albuterol are used for acute asthma or COPD exacerbations.
Correct Answer is C
Explanation
Choice A reason: Loratadine has no significant advantage in reducing cardiac dysrhythmias compared to diphenhydramine. Both are H1 receptor antagonists, with minimal cardiac effects at therapeutic doses. Older antihistamines like terfenadine had dysrhythmia risks, but loratadine and diphenhydramine are not primarily associated with this issue.
Choice B reason: Loratadine causes minimal gastrointestinal upset, but this is not its primary advantage over diphenhydramine. Both antihistamines have low gastrointestinal side effects, with diphenhydramine’s anticholinergic effects causing more dry mouth. Loratadine’s key benefit is reduced CNS penetration, minimizing sedation.
Choice C reason: Loratadine, a second-generation antihistamine, has less sedative effect than diphenhydramine, a first-generation antihistamine. Its reduced ability to cross the blood-brain barrier minimizes H1 receptor blockade in the CNS, decreasing drowsiness, making it ideal for daytime use in allergic conditions.
Choice D reason: Neither loratadine nor diphenhydramine significantly increases bronchodilation. Antihistamines block histamine-mediated allergic responses, not beta-2 receptors responsible for bronchodilation. Bronchodilation is achieved with beta-agonists like albuterol, making this an incorrect advantage for loratadine over traditional antihistamines.
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